Base of Thumb Arthritis

Thumb arthritis is common with aging and occurs when cartilage wears away from the ends of the bones that form the joint at the base of your thumb — also known as the carpometacarpal (CMC) joint.Thumb arthritis can cause severe pain, swelling, and decreased strength and range of motion, making it difficult to do simple tasks, such as turning doorknobs and opening jars. Treatment generally involves a combination of medication and splints. Severe thumb arthritis might require surgery.

Signs and Symptoms

Pain is the first and most common symptom of thumb arthritis. Pain can occur at the base of your thumb when you grip, grasp or pinch an object, or use your thumb to apply force.

Other signs and symptoms might include:

  • Persistent swelling, stiffness and tenderness at the base of your thumb
  • Decreased strength when pinching or grasping objects
  • Decreased range of motion
  • Enlarged or bony appearance of the joint at the base of your thumb



Thumb arthritis commonly occurs with aging. Previous trauma or injury to the thumb joint also can cause thumb arthritis. In a normal thumb joint, cartilage covers the ends of the bones — acting as a cushion and allowing the bones to glide smoothly against each other. With thumb arthritis, the cartilage that covers the ends of the bones deteriorates, and its smooth surface roughens. The bones then rub against each other, resulting in friction and joint damage.



During a physical exam, Dr Zadeh will ask about your symptoms and look for noticeable swelling or lumps on your joints.

Dr Zadeh might hold your joint while moving your thumb, with pressure, against your wrist bone. If this movement produces a grinding sound, or causes pain or a gritty feeling, the cartilage has likely worn down, and the bones are rubbing against each other.


Non Operative Treatment


In the early stages of thumb arthritis, treatment usually involves a combination of non-surgical therapies. If your thumb arthritis is severe, surgery might be necessary.


To relieve pain, Dr Zadeh might recommend:

  • Topical medications
  • Over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Motrin IB, others) or naproxen sodium (Aleve)
  • Prescription pain relievers, such as non steroidal anti-inflammatory (NSAIDS)



A splint can support your joint and limit the movement of your thumb and wrist. You might wear a splint just at night or throughout the day and night.

Splints can help:

  • Decrease pain
  • Encourage proper positioning of your joint while you complete tasks
  • Rest your joint



If pain relievers and a splint aren’t effective, Dr Zadeh might recommend injecting a long-acting corticosteroid into your thumb joint. Corticosteroid injections can offer temporary pain relief and reduce inflammation.

Surgical procedure

If you don’t respond to conservative treatments and if you cannot use your thumb for daily tasks, Dr Zadeh might recommend surgery Typically, Dr Zadeh will perform removal of a small bone in the wrist joint (trapeziumectomy) and an athroplasty of the base of the thumb.

After surgery Dr Zadeh will give you guidelines to follow

Risks and Complications

As with any major surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place.

The majority of patients suffer no complications, however complications can occur and include :

  • Infection
  • Injuries to surrounding tendons or nerves
  • Stiffness of the thumb and wrist
  • Sensitive scar

Risk factors that can negatively affect adequate healing after surgery include:

  • Poor nutrition
  • Smoking
  • Alcoholism
  • Chronic illness
  • Steroid use

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